THE PUBLIC HEALTH IN BRITISH COLUMBIA

THE PUBLIC HEALTH IN BRITISH COLUMBIA

870 leads to loss of sexual characteristics and atrophic locating the needle. Dr. Skillern’s method of findingchanges. Its influence on the suprarenal...

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870 leads to loss of sexual characteristics and atrophic locating the needle. Dr. Skillern’s method of findingchanges. Its influence on the suprarenal and a needle without a skiagram depends upon the rigid, thyroid, on the other hand, may be regarded as observance of four rules: 1. The field must be inhibitory, and decrease of its function may allow absolutely bloodless. This is attained by exsan. of a hyper-functioning of these organs, with, in the guinating the tissues from the fingers or toes to, case of the former, symptoms of hyperadrenalism above the elbow or knee by a Martin’s bandage and development of secondary male sexual charac- The first turns are uncoiled sufficiently to expose teristics. The association of changes in secondary the field of operation; the remaining turns keep. the blood back. 2. Follow the black track which sex characters and impairment of function of the suprarenal cortex is well established and has leads from the skin puncture to the needle. The received considerable publicity. The term " supra- success of this step depends on that of the first. renal virility " has been applied in France to those 3. Efficiently retract the tissues. 4. Lose no timefemale cases which as a result of suprarenal disease in searching through the fat, since the needletake on the secondary sex characters of the opposite travels directly to deep fascia or bone, the subsex. cutaneous fat being too soft either to break orstop it. At the moment of impact the elastic fat is. THE PUBLIC HEALTH IN BRITISH COLUMBIA compressed and the needle is driven into and. IT is not unnatural that the public health report caught in a strong grip by the dense palmar or for British Columbia, which was recently noticed plantar fascia or by bone. When the pressure is. in our columns,l should be, as we said, exiguous, released the elastic fat springs back into place and,for the Province, with its enormous extent and as it were, swallows up the needle. With the its population of 400,000, has had no medical officer patient properly anaesthetised a free incision is. since February, 1914, when the late Dr. Fagan made directly down to the deep fascia. Its length retired. Since that time the health work of the varies directly with the depth of the subcutaneousProvince has been done by Dr. Bapty, formerly the fat. In some cases time is gained by adding another so as to make a T-incision, or even a crucial bacteriologist, also in general practice, but since limb incision may be necessary. The incision includes. he has been on service as a major in the the skin puncture and the black track is exposed Canadian Mounted Rifles the office has been to the deep fascia. The latter is and followed in charge of a sanitary inspector. A local correthoroughly by retracting the flaps. The exposed is us that this a most tells spondent gentleman needle is usually found sticking into the deep able courteous but official, competent scarcely to deal with the problems brought for discussion fascia. If it has penetrated more deeply this must be incised and retracted. The underby medical officers and sanitary engineers. There fascia muscles or tendons are examined each in lying have been protests from the medical profession its own plane. This method of "plane dissecof and this state the matter has things, against been mentioned in the election campaign now pro- tion"is very important. If the needle is not in plane it must be in some other, and each plane ceeding, while the situation may entail increasing one must be successively explored. Before each plane damage to health in the province. So progressive is dissected it is palpated with the tip of the little a colony as British Columbia should at once get or with the handle of the knife, finger explored dark out of the the herself care ages by putting of her public health in the hands of a medical officer. which may scrape against the needle. The bones Dr. Bapty did good work by urgently pressing pre- form the last plane, and when they are reached the ventive inoculation against typhoid fever on the needle has probably been found. It should be carefully extracted in its own axis, for it is liable population even before the war. to break. By this plan the usual causes of failuretoo small an incision and insufficient retractionare eliminated, and, contrary to prevailing opinion, THE EXTRACTION OF NEEDLES. a skiagram is not always essential. ’ THE extraction of needles from tissues falls to the lot of every practitioner. and when access to the X rays is not possible, as frequently happens, THE LATE DR. A. A. W. HUBRECHT. the operation may be very difficult. In the InterTHE death of Dr. Hubrecht has removed a very state Medical Journal Dr. P. G. Skillern has considerable of needles person from the zoological world. published a paper on the extraction without this aid containing many useful hints. For Among those who have devoted themselves entirely anaesthesia local infiltration with novocain-supra- to the purely zoological side of biology--not being renin solution usually suffices, but nitrous oxide concerned, that is, with the more theoretical may be used as well. In the hand the needle is aspects of that science, heredity, sex, and so forthusually driven in by the sewing machine, and since Hubrecht has occupied for some years a prominent the eye is at the point goes eye foremost. Hence if position. His researches have been mainly along. The best-known work, perhaps because. a thread is carried in no attempt should be made to two lines. extract the needle by traction on the thread, not it took up many more years in its execution, dealt only for reasons that are obvious, but also because with the group of worms usually called nemertina. the thread forms a valuable guide to the position A reference to any zoological text-book or treatise of the needle. In the foot the needle is also driven will at once show the large number of important canin eye foremost, since it is usually an ordinary tributions which this zoologist has made to our undersewing needle that has been stuck in the floor. standing of those animals. The genus Hubrechtia The same holds for another common situation-the remains as a sign of his acknowledged mastery buttocks. The diagnosis is made by the history, the of this group. In more recent years Dr. Hubrecht presence of a punctured wound, abiding pain, and devoted a great deal of attention to the developespecially by -an area of circumscribed induration ment of the mammalia; while besides these two and tenderness at one spot. The last is important inL main lines of work he contributed memoirs on various biological topics. Dr. Hubrecht was par1 THE LANCET, March 6th, 1915, p. 505. ticularly well known in this country by season of ____

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